ACPHS Professor of Pharmacy Practice, Tom Lodise, PharmD, explains that Anti-Microbial Resistance (AMR) threatens the foundation of modern medicine, making once-routine infections increasingly difficult to treat. He was recognized in August of this year by the Antibacterial Leadership Resistance Group as a Highly Ranked Scholar – Prior 5 Years, for his publications on vancomycin, as well as one of the top authors ever cited (putting him at the top two percent of cited authors historically) within Scopus, Elsevier‘s 36K-plus title database.
In honor of WHO’s World AMR Awareness Week, from November 18-24, we asked Dr. Lodise to talk to us about his research and how it aims to improve care for patients with AMR infections.
Why is antimicrobial resistance a major health threat?
Antimicrobial resistance means the antibiotics we have depended on for decades are losing their power. Most infections are still treatable today, but each year more than 2.8 million resistant infections occur and over 35,000 people die as a result in the U.S., according to the CDC.
About 30 percent of the nearly 12 million adults treated for infections in hospitals, whether admitted with one or developing it during their stay, do not receive an active antibiotic within the first three days. Delays in appropriate therapy lead to more complications, deaths and higher costs. Without effective antibiotics, the very foundation of modern medicine begins to crumble. Safe childbirth, organ transplants, joint replacements and cancer chemotherapy all depend on being able to prevent and treat infections. Losing antibiotics would set medicine back a century.
How do pharmacometrics, outcomes research and epidemiology fit together?
Antimicrobial resistance threatens the foundation of modern medicine, making routine infections harder to treat. My research program brings together pharmacometrics, clinical outcomes research, and epidemiology to improve care for patients with resistant infections.
The goal is to develop treatment strategies that are more personalized, safer and more effective while reducing drug toxicity and slowing the spread of resistance. Using advanced modeling, we study key processes of care such as how quickly patients receive the right therapy, how rapid diagnostics guide treatment, and how therapeutic drug monitoring improves outcomes. By linking how antibiotics move through the body with how they act against bacteria, we can define exposure levels that achieve cure without causing harm. This approach helps translate complex data into practical strategies that clinicians can use to deliver better care for patients today and preserve antibiotic effectiveness for the future.
What have you learned about dosing and exposure?
We have learned that getting the right amount of antibiotics to the infection site at the right time can be the difference between success and failure. Too little drug allows infection and resistance to persist, while too much increases the risk of toxicity. Even small differences in kidney function or body size can dramatically alter antibiotic levels. Through modeling and simulation, we can predict these variations and individualize therapy. This approach allows us to ensure that every patient receives enough drug to cure the infection while minimizing the risk of harm.
How do you balance aggressive treatment with stewardship?
Clinicians face a constant challenge: treating infections strongly enough to save lives but not so broadly that it accelerates resistance. Our research provides data that helps clinicians strike that balance.
By identifying optimal dosing, limiting unnecessary exposure, and using rapid diagnostics to target therapy, we can treat infections effectively while preserving the usefulness of antibiotics. Stewardship is not about restricting care; it is about using antibiotics wisely and precisely so they continue to work for the next patient who needs them.
What needs to change going forward?
We need to modernize how we discover, evaluate, and use antibiotics. This means developing new drugs and diagnostics but also making smarter use of the ones we already have. Clinically, we must embrace individualized dosing, integrate real-time data into care decisions, and expand stewardship programs across health-care systems.
On the policy side, we need sustained investment in research, surveillance and public health infrastructure. If we bring science, policy and clinical practice together, we can preserve the power of antibiotics and ensure that serious infections remain treatable for generations to come.
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